16993_BLIZZARD, J E_19970212

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CAMA AND DREDGE AND FILL
GENERAL PERMIT � y
as authorized by the State of North Carolina a
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC ''-
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier dock) length .
i
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
y
cubic yards
Boat ramp dimensions
Other
Phone Number
State
Zip - •
(SCALE: )
i
1't v r� 1 � # r •
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance
The applicant certifies by signing this permit that 1) this pro
ject is consistent with the local land use plan and all Iota
ordinances, and 2) a written statement has been obtained frorr
adjacent riparian landowners certifying that they have nc
objections to the proposed work.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coasta
Management Program.
Y
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

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CERTIFIED MAIL,
RETURN RFCFLPT REQtj-_F
Dear
This letter is to notify you as an adjacent riparian landowner of Mr/Mrs
plans to construct
on their property l a
I-
1 n
proposed c istruction.
, NL. The sketch on the reverse side accurately depicts the
Should you have no objections to this proposal, please check the statement below, sign
and date the blanks below the statement, and return this letter to:
as so6fi(As possible.
Should you have objections to this proposal, please send your written comments to the
N.C. Division of Coastal Management, P. 0- Box 769, Morehead City, NC, 28557. Written
comments must be received within ten (10) days of receipt of this notice.
Failure to respond in either method within ten 1(lj days will be interpreted as no
objection. -
Sincerely,
I have no objection to the project as presently proposed and hereby waive that
right of objection as provided in General Statute 113-229.
I have objections to the project as presently proposed and have enclosed
comments.
Signature
DATE:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to , �� 's
(Nai a of Property Owner)
property located at / c� 7 ,_ 6,,�/r1 2, •
(Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Signatu
/,/ [
Print or Typ6 Name
Telephone Numb r
Date:

CFRTIFIFD NtAII,
RETURN RECEIPT RF IJFSTFn
Dear .
This letter is to notify you as an adjacent riparian landowner of Mr/Mrs
_plans to construct
on their property 1 ated at
J
in NC. The sketch on the reverse side accurately depicts the
proposed c istruction.
Should you have no objections to this proposal, please check the statement below, sign
and date the blanks below the statement, and return this letter to:�
as so6h(As possible.
Should you have objections to this proposal, please send your written comments to the
N.C. Division of Coastal Management, P. 0. Box 769, Morehead City, NC, 28557. Written
comments must be received within ten IO) days Af receipt Pf this notice.
Failure to respond in either method within ten—(1ffi days will be interpreted as no
Objection.
Sincerely,
I have no objection to the project as presently proposed and hereby waive that
right of objection as provided in General Statute; 113-229.
I have objections to the project as presently proposed and have enclosed
comments.
Signature
DATE:
w

lei
1
�I

--- - - �- roe_ \

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
on
(Name of Property Owner)
•
(Lot, Block, Road, etc.)
7s
in . N. C.
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
8
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
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Signatu e—e' 1� (- , , ` M
Print or Type Name
Telephone Number
Date:
f S 1 .
E.C.M.
oeo
i-f`_N CE
U.2S-�r�vER

JACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ,$
(Naive of Property Owner)
property located at
(Lot, Block, Road, etc.)
on , in(Waterbody) , N.C.
(Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
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Signature
Print or T ame
Telephone Mumber
i
Date: 1-/-7